Sleeve sphincter of Oddi (SO) manometry: a new method for characterizing the motility of the sphincter of Oddi

Abstract

Background/Purpose Perfused multilumen sphincter of Oddi (SO) manometry is accepted as the gold standard for diagnosis of SO dysfunction. However, this technique is associated with a relatively high incidence of post-procedure acute pancreatitis. In addition, triple-lumen manometry recordings may be difficult to interpret, as movement may produce artifacts. We have refined the development of a sleeve sensor for human SO manometry. This assembly aims to overcome the above limitations. In this study the accuracy of sleeve SO manometry (SOM) has been evaluated and compared with standard triple-lumen perfused SOM. Methods Patients undergoing SO manometric studies consented to having both standard triple-lumen and sleeve SOM. A total of 32 paired studies were performed in 29 patients. Diagnosis was made only from standard triple-lumen SOM and the patient treated accordingly. For each study, SO basal pressure, contraction, amplitude, and frequency were recorded. Results There was no statistically significant difference in the recordings of SO basal pressure, contraction, amplitude, and frequency between the two techniques. A strong correlation was demonstrated between SO basal pressure determined with the two catheters. The accuracy of sleeve SOM is comparable to standard triple-lumen SOM, with less movement artifact. One patient developed mild post-manometric pancreatitis. Conclusions The sleeve catheter records SO pressures with comparable values to standard triple-lumen SOM. The sleeve assembly potentially can replace the use of the perfused triple-lumen catheter for the objective diagnosis of SO dysfunction.